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Jafarpour D, El-Amier N, Feine J, Bedos C, Abi-Nader S, Esfandiari S, Shuster T, Zimmermann E, de Souza R. 3D printing vs traditional workflow for the fabrication of mandibular implant overdentures: study protocol for a mixed-methods cross-over RCT. Trials 2024; 25:267. [PMID: 38627819 PMCID: PMC11022432 DOI: 10.1186/s13063-024-08097-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Complete tooth loss is a significant global oral health issue, particularly impacting older individuals with lower socioeconomic status. Computer-assisted technologies enhance oral healthcare access by the elderly. Despite promising in vitro reports on digital denture materials, evidence from randomized clinical trials (RCTs) is lacking to verify their performance. This cross-over RCT will investigate whether 3D-printed implant-retained mandibular overdentures (IMO) are more satisfactory for edentulous seniors than those made through traditional methods. METHODS/DESIGN We will recruit 26 completely edentulous participants (any sex/gender) based on the following eligibility criteria: age ≥ 60 years, no tooth extraction in the past 12 months, two implants in the lower jaw, and need for new dentures in both jaws. Each participant will receive two denture pairs, either manufactured by 3D printing or traditionally, to be worn in a random order. A timeline of 3 months with each denture pair will be considered for outcome assessment (total: 6 months). Patient satisfaction with dentures will be measured by the McGill Denture Satisfaction Questionnaire. We will evaluate other patient-reported outcomes (including oral health-related quality of life) as well as clinician-assessed quality and cost. At the end of the trial, participants will choose which denture pair they wish to keep and interviewed about their experiences with the 3D-printed IMO. The quantitative and qualitative data will be incorporated through an explanatory mixed-methods strategy. A final quantitative assessment will happen after 12 months with the preferred IMO to assess the long-term performance and maintenance needs. DISCUSSION This mixed-methods RCT will explore patient experiences with 3D-printed IMOs, aiming to assess the potential for altering clinical practice and dental public health policies. Our results will inform policies by showing whether 3D printing offers comparable outcomes at lower costs, facilitating greater access to oral care for the elderly. TRIAL REGISTRATION ClinicalTrials.gov, NCT06155630, Registered on 04 December 2023. https://classic. CLINICALTRIALS gov/ct2/show/NCT06155630.
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Affiliation(s)
- Dana Jafarpour
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Nesma El-Amier
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
- Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Jocelyne Feine
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Christophe Bedos
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Samer Abi-Nader
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Shahrokh Esfandiari
- Faculty of Dental Medicine, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Tibor Shuster
- Department of Family Medicine, McGill University, Montreal, Canada
| | - Elizabeth Zimmermann
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Raphael de Souza
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada.
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Shrivastava R, Luxenberg R, Sutton E, Emami E. Patients experience and satisfaction with immediate loading of implant-supported overdentures - A qualitative study. J Dent 2023; 137:104644. [PMID: 37527728 DOI: 10.1016/j.jdent.2023.104644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVES To explore the perspectives and experiences of edentate individuals in regard to the immediate-loading protocol of an implant-supported overdenture. METHODS A qualitative approach and interpretive description methodology was used. Seventeen edentate individuals (mean age: 61.9 ± 6.6 years) who received implant-supported overdentures through an immediate-loading protocol participated. Audio-recorded, semi-structured, in-depth interviews, each with a 60-90-minute duration, were conducted by two trained interviewers. The interview guide was developed based on Perneger's Detailed Model. Qualitative data were analyzed using a thematic approach including interview debriefing, transcript coding, data display, inductive thematic analysis, and interpretation. RESULTS Three main themes emerged from the interviews: patient awareness and engagement with treatment, experience-shaped expectations, and immediate gratification. All patients expressed satisfaction with the treatment. Providing detailed information, good communication, and accessibility of the dental care provider had a significant impact on patient satisfaction with prosthetic care. Patients highlighted that the high cost of implant therapy was the major barrier to receiving this treatment in the private sector and perceived dental insurance coverage as a facilitator of this process. CONCLUSIONS Study findings conclude that patient awareness about immediate-loading protocol improved their treatment engagement, and patient satisfaction with the treatment outcomes was higher than anticipated. The satisfaction was primarily related to prosthesis stability, receiving the prosthesis the same day, and low cost of treatment. Patients' positive experience and satisfaction with the immediate-loading protocol indicate that this treatment modality should be considered in treatment planning for edentate individuals. CLINICAL SIGNIFICANCE The perceptions and experiences of edentulous patients gathered in this study highlight their satisfaction with immediate loading for implant-supported overdentures. This therapeutic modality can be considered a viable option in treatment planning for edentulous individuals.
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Affiliation(s)
- Richa Shrivastava
- Faculty of Dentistry, University of Montreal, 2900 Boulevard Edouard-Montpetit, Montreal, QC, Canada
| | - Ryan Luxenberg
- Faculty of Dentistry, University of Montreal, 2900 Boulevard Edouard-Montpetit, Montreal, QC, Canada
| | - Edward Sutton
- Faculty of Dentistry, University of Montreal, 2900 Boulevard Edouard-Montpetit, Montreal, QC, Canada
| | - Elham Emami
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, 2001 McGill College Avenue, Suite 500, Montreal QC H3A 1G1, Canada.
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Patil PG, Seow LL. Oral health-related quality of life of patients using single or two-implant mandibular overdentures with immediate loading protocols: A randomized controlled trial. J Indian Prosthodont Soc 2021; 21:375-382. [PMID: 34810365 PMCID: PMC8617442 DOI: 10.4103/jips.jips_328_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Aim: Single implant-retained mandibular overdentures (1IMO) is a viable alternative to 2 implant-retained overdentures (2IMO) in edentulous patients. However, literature lacks in the quality of life (QoL) of these patients when treated with immediate loading protocols. The purpose of this study was to compare oral health-related QoL (OHRQoL) of patients using 1IMO or 2 IMO with immediate loading protocols at 1 month and 1 year. Settings and Design: Randomized Controlled Trial. Materials and Methods: Fifty-two edentulous participants treated with mandibular overdentures using either single implant (n = 26) or two implants (n = 26) with immediate loading protocol by a single operator. The low-profile stud-attachments (LOCATOR; Zest Anchors) were attached to the implants and female attachments were picked up within 0–7 days of implant placement. The OHRQoL was recorded using Oral Health Impact Profile-14 (OHIP-14) questionnaire either in English or in the Malay language before treatment and 1 month and 1 year after treatment. Statistical Analysis Used: Kruskal Wallis test was used to find out significant difference amongst 3 timepoints and 7 OHIP-14 domains and Mann-Whitney-U test to compare 1IMO or 2IMO groups. Results: Compared to baseline OHIP-14 scores, participants had a statistically significant decrease in total OHIP-14 at 1 month and 1 year after-treatment time points in both 1IMO and 2IMO groups (P < 0.05). The difference between 1 month and 1 year after-treatment total and subscale scores were also found to be statistically significant (P < 0.05). The overall QoL improvement was comparatively higher in 2IMO group than 1IMO group. The OHIP-14 scores were statistically different within seven domains (P < 0.05). Overall total scores between 1IMO and 2IMO groups were also found to be statistically significant (P < 0.05) at baseline and insignificant (P > 0.05) at 1 month and 1 year. Conclusions: Mandibular single and 2IMO improve the QoL of elderly edentulous Malaysian participants at 1 month of immediate loading and 1 year of recall. 1IMO may provide comparable QoL with the elderly patients using 2 implants.
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Affiliation(s)
- Pravinkumar G Patil
- Department of Prosthodontics, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Liang Lin Seow
- Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
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de Resende GP, Dias AP, Leles JLR, de Souza JAC, Leles CR. Postsurgical oral symptoms after insertion of one or two implants for mandibular overdentures: short-term results of a randomized clinical trial. Int J Implant Dent 2021; 7:38. [PMID: 33907936 PMCID: PMC8079530 DOI: 10.1186/s40729-021-00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/17/2021] [Indexed: 11/24/2022] Open
Abstract
Objective This randomized clinical trial aimed to compare the short-term postsurgical symptoms after insertion of one or two implants for retention of a mandibular overdenture. This study investigated whether the less invasive single-implant approach results in lower postoperative symptoms compared to the conventional two-implant overdenture. Materials and methods Patients received new complete dentures and were randomly assigned to groups receiving one or two single-stage, early-loaded hydrophilic implants, inserted in the midline (n = 23), or the lateral incisor-canine area bilaterally (n = 24). Patient-reported postoperative symptoms were measured in a 0–100 visual analogue scale concerning pain in the surgical area, pain when chewing, bleeding, swelling, and unpleasantness. Data collection occurred 24 h and 7 and 21 days after surgery. Demographic and clinical features (smoking habit, classification of the residual ridges, and mucosal width and thickness at the implant sites), osteotomy for alveolar bone reduction, and surgery time were tested as predictors of symptom levels. Results Overall reported symptoms were mild and self-limited, with high rates of complete remission after the early loading period of 3 weeks. Progressive improvement of symptoms occurred from the 24-h to the 7-day and 21-day follow-ups (p < 0.001), similarly in both groups. None of the clinical predictors was significantly associated with the changes in symptoms. Conclusions Findings suggest that the insertion of one or two implants may result in similar postoperative outcomes. Clinical relevance The severity of short-term postoperative symptoms may not be a critical factor for the decision between overdenture treatment with one or two implants.
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Affiliation(s)
- Gabriela Pereira de Resende
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goias, Praça Universitária, s/n, Setor Universitário, Goiania, Goias, 74605-220, Brazil
| | - Ana Paula Dias
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goias, Praça Universitária, s/n, Setor Universitário, Goiania, Goias, 74605-220, Brazil
| | - José Luiz Rodrigues Leles
- Private Practice, Goiania, Goias, Brazil.,School of Dentistry, Campus Flamboyant, Paulista University, Rodovia BR 153, Km 503, s/n Fazenda, Marginal Botafogo, Goiania, Goias, 74845-090, Brazil
| | - João Antônio Chaves de Souza
- Department of Stomatology (Periodontology), School of Dentistry, Federal University of Goias, Praça Universitária, s/n, Setor Universitário, Goiania, Goias, 74605-220, Brazil
| | - Cláudio Rodrigues Leles
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goias, Praça Universitária, s/n, Setor Universitário, Goiania, Goias, 74605-220, Brazil.
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Mahgoli H, Asadi S, Hajmahmoudi M, Moharrami M, Arshad M. Mandibular Overdentures Supported by Two vs Four Endosteal Implants: A Retrospective Cohort Study. J Contemp Dent Pract 2019; 20:582-586. [PMID: 31316022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIM Documentation of marginal bone resorption caused by implant-supported mandibular overdentures is scarce. This study sought to evaluate marginal bone resorption, survival rate, patient satisfaction, peri-implant soft tissue status, and prosthetic aftercare of mandibular overdentures supported by two vs four implants. MATERIALS AND METHODS This retrospective cohort study evaluated 92 edentulous patients presented to the Implant Center of Tehran University of Medical Sciences; out of which, 46 patients received overdentures supported by two Implantium implants (group A), while the remaining 46 received overdentures supported by four Implantium implants (group B). Standard radiographic indices were assessed following the delivery of overdenture and after 2 years of functional loading. Clinical evaluation was performed after 2 years of function. Data were analyzed using the t test (for continuous variables) and the Mann-Whitney test (for ordinal variables). RESULTS In group A, two implants were lost in one patient. The groups were not significantly different in terms of clinical or radiographic parameters (p > 0.05). Patient satisfaction and prosthetic aftercare were not significantly different in groups A and B (p > 0.05). CONCLUSIONS During the 2-year evaluation period, the clinical and radiographic parameters were the same in patients who received overdentures supported by two or four implants. CLINICAL SIGNIFICANCE Successful results may be obtained by the use of mandibular overdentures supported by two or four implants.
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Affiliation(s)
- Hoseinali Mahgoli
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Prosthodontics, International Campus, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Asadi
- Dental Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Hajmahmoudi
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Prosthodontics, International Campus, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Moharrami
- Dental Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Arshad
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Prosthodontics, International Campus, School of Dentistry, Tehran University of Medical Sciences, Khani Abad, Tehran, Iran, Phone: +98 2122273471, e-mail:
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